FEBRUARY 11, 2019
ORLANDO, FL
www.HIMSSConference.org
#EngageHealth
“Is This for You or for Me?”
Best Practices for Co-Designed Patient Information
Objectives
• Identify a patient identified best practice in documenting medical conditions
• Outline the key information to be included on the After Visit Summary identified
as most important to patients
• Describe how human-centered design may be utilized to co-design technology
informed patient documentation
Form vs Function
“I recently attempted to sign in for an
appointment at a kiosk. I was asked to
agree to several multi-paged
documents. Are you kidding? Who's
going to stand there and read all those
pages?... makes me think you don't want
people reading what they're signing?”
Courtesy of Russell Flench
Education: Ileostomy Surgery
Discharge
The Bill
The “Problem” List
Problem List: Renew
Confidential.
SITUATION, CHALLENGE, AND RESOLUTION
Situation
Challenge
Resolution
To best support patients in their healthcare, how might we share sensitive
information in ways that instill trust, confidence in the care provided, and
allows for engagement in the plan of care?
Patients desire access to documentation and increasing access. They
own their information, and transparency allows more control over their
healthcare. Yet, we struggle to provide meaningful information to patients,
particularly when is comes to medical conditions.
Trust derives from accurate & transparent communication with aligned
documentation, co-designed by patients.
Literature
• Benefits to patients
• Challenges
- 59-62% of patients would like to add comments to notes
- 1/3 believe they should approve notes - Clinicians
disagree
- Nearly ½ identified at least 1 major or minor problem
missing
• Recommendations for documenting
Source: Vodicka et al., 2013; Delbanco et al., 2012, Kahn et al., 2014; Wibe et al., 2013; Wright et al., 2014
Human-Centered Design Methods
Cleveland Clinic
Discovery / Research
Primary
Secondary
Ethnography
Observations
Concept Development
Prototyping
Co-creation sessions
Design principles
Storyboarding
Implementation
Piloting
Measure
Evaluate
Human-Centered Design
Humanistic Care
Mechanistic Care
Implementation
Discovery
Service
Technological
and Device
Biomechanical
Research
Quality and Safety
Evolved from Case Western / Cleveland Clinic Project Report
Design-Led Company Performance
$40,000
$30,000
$20,000
$10,000
Over a ten-year period, design-led companies outperformed the S&P 500 by 219 percent
Value of $10,000 investment
Note: Analysis is based on weighted market cap and excludes dividends; Source: Design Management Institute; Motiv Strategies
Design Value Index
$29,427
S&P 500
$17,999
+219%
2004
2006
2008
2010
2012 2014
Analytical
“I do truly feel like doctors treat
you QUITE differently based on
the codes on your chart.”
Accepting
“I’ve got quite a few issues.
So it’s a little
overwhelming…”
Skeptical
“Is this for you or
is this for me?”
• 10 Guiding Principles
• 44 Recommendations
- Design
- Documentation
- Communication
Problem List: Recommendations
The “Problem” List
After Visit Summary: Project Start
•Provide clarity on rationale for diagnosis & recommendations
•Organize, categorize, & simplify information
•Ask patient to review & update electronically prior to visit & follow
up in conversation
•Streamline information on the AVS to information pertinent to that
particular visit with prompts to MyChart for a complete record
•Invite the patient to update the medical list online.
•Use language that asks the patient to speak up if errors are noted
Recommendations
The Problem is the “Problem” List
Insight
Trust is complicated
Insight
“you try to ask nowadays for them to be like ‘Oh, what do I
have? What’s my diagnosis?’ And they’re just ‘Oh they’re all
the same,’ which when you’re the patient isn’t really the
thing.”
Our Voice: Healthcare Partners
MISSION
Improving Healthcare through Collaboration
VISION
Patients & Caregivers as Partners for Better Health
PRINCIPLES
Transparency
Co-
Leadership
Co-Design
Proactive &
Committee
Work
Community
Be Intentional in Partnership
Healthcare Partners who identified that
access was important to them, and who
have utilized surgical access at Cleveland
Clinic, came together to inform design
prototypes for Surgical Access.
Intentional Partnership
• Patients want to be treated holistically & share their
information transparently & struggle to trust
• Move from language of Problem to Diagnoses
• Simplify content to that particular visit
• Focus on what matters most to
patients…communicating what is it, how do you
know, why recommending what you are…
Key Takeaways
• Healthcare Partners –Patients &
their Loved Ones
• Adrienne Boissy
• Rob Lorenz
• Jolene O’Callaghan
• Ashley Radar
• Russell Flench
• Elliott Wortham
• The Insights Lab
• McKinley Kelcy
• Paul Ford
• Susannah Rose
• Judy Morgan
• Dyan Colpo
• Paul Kuzimickas
• Tara Sammon
• Amy Szabo
Acknowledgements
www.HIMSSConference.org
#EngageHealth
Julie Rish, PhD
Cleveland Clinic
@julie_rish
